Objective: To evaluate the results of renal function after percutaneous nephrostomy in hydronephrotic kidneys in adult population. Methods: This study was performed on 57 patients of more than 18 years of age with hydronephrosis due to PUJ obstruction and split renal function <10% at the Department of Urology, Dhaka Medical College Hospital. Patients with concomitant pathologies like stone, pyonephrosis and VUJ obstruction were excluded from the study. Their evaluation included split renal function (SRF),glomerular filtration rate (GFR),specific gravity of urine draining through nephrostomy tube,volume of urine through nephrostomy tube. Statistical analysis was performed by SPSS version 13 and the test statistics used to analyse the data were descriptive statistics and Repeated measure ANOVA. Results: Mean age of the patients was 33.4+13.0 years, mean SRF increased from 6.2% at baseline to 18.6% after 6 weeks of PCN (p < 0.001), mean GFR increased from 6.2 ml/min/1.73 sq-meter at baseline to 18.6 ml/min/1.73 sq-meter at the end of week 6,mean specific gravity of urine significantly increased from 1.009 at baseline to 1.019 after 6 weeks, volume of urine at 2nd week was 316 ml/ 24 hours and nearly 363 ml/ 24 hours after 6 weeks of PCN (p < 0.001).GFR and SRF improved in 78.95% case Conclusions: Most of the poorly functioning hydronephrotic kidneys showed functional improvement following PCN and hence not all such kidneys should be removed without subjecting them to a trial of PCN. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.93-97

Objective: To assess the role of flexible cystoscopy in the diagnosis of lower urinary tract pathology and its suitability as a routine diagnostic protocol in outdoor patients. Methods: The cross sectional study was conducted at the advanced centre of kidney diseases and urology, Dhaka central international medical college, Dhaka from Jan 2016 to jan2019. All adult patients presenting with lower urinary symptoms to outdoor department were included. Flexible Cystoscopy was performed as a outdoor based procedure without sedation. Results: Of the 249 patients in the study,198(79%) were male and 51(21%) were female. Lower urinary tract pathologies were found in 192(72%) patients. The most common pathology among males was enlarged prostate 56(31%) patients. Urethral stricture, bladder neck high were found 23(11%),21(10%) respectively. Among females, urethral stenosis was the most common pathology in 23(32%)patients. Transitional cell carcinoma was seen in 11(4.4%) patients having hematuria with inconclusive ultrasound and intravenous urography. .All patients tolerated the procedure well with no procedure related complaints. Conclusion: Flexible cystoscopy is an effective, well tolerated and easy way of detecting lower urinary tract pathologies. It can alter the management as well as support the diagnosis and management. It is also helpful in routine surveillance of bladder tumours of low grade and low stage. Flexible cystoscopy should therefore be used as routine diagnostic protocol in outdoor practice. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.151-153

Background: Ureteropelvic junction obstruction leads to progressive dilatation of the renal collecting system, and can result in pain and progressive deterioration of renal function but may be asymptomatic and result in complication such as pyelonephritis,calculus formation and deterioration of renal function may ensue if left untreated.Open pyeloplasty remains the gold standard against which new technique must be compared.we compared laparoscopic and open pyeloplasty in the treatment of pelviureteric junction obstruction. To see the outcome of laparoscopic pyeloplasty versus open A-H pyeloplasty in the management of pelviureteric junction obstruction. Methods and materials: A prospective quasi experimental study was done from july 2012 to December 2013 in which a total of 30 laparoscopic and 30 open pyeloplasty were done. All laparoscopic pyeloplasties were performed transperitoneally.Standard open A H pyeloplasty,spiral flap or VY plasty was done depending on anatomical consideration. Patients were followed with USG and IVU at three and six months interval.Perioperative parameters including operative time,analgesic use,hospital stay,and complication and success rates were compared. Results: Mean total operative time in LP group was 115±15 min compared to 75 ±15 in OP group, the postoperative analgesic requirement was sighnificantly less in LP group(mean 84.73±11mg) and OP group required mean of( 274.33±39.42mg).The mean blood loss in LP group was 118.26±110.74ml compared to open group 274.82±118.97ml.The postoperative hospital stay in LP was mean 4 days(2-7days) sighnificantly less than the open group mean of 8 days(7-9days). Conclusion: Lp has a minimal level of morbidity and short hospital stay compered to open approach.Although laparoscopic pyeloplasty has the disadvantages of longer operetive time and requires sighnificant skill of intracorporal knotting but it is here to stay and represents an emerging standard of care. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.182-187

Background: Retrocaval ureter also referred to as circumcaval ureter or preureteral venacava is a rare congenital anomaly with the ureters passing posterior to the inferior vena cava (IVC). The ureter classically course medially behind the inferior venacava winding around it and then passes laterally in front of it to then course distally to the bladder. Though it is a congenital anomaly, patients do not normally present with symptoms until the 3rd and 4th decades of life from a resulting hydronephrosis. This hydronephrosis may be due to kinking of the ureter. The ureteric segment is a dynamic or compression against the psoas muscle. It was initially considered as aberration in ureteric development; however current studies in embryology have led to it being considered as an aberration in the development of the inferior vena cava. Objectives: The aim of our study was to explore the safety, feasibility and usefulness of retroperitoneoscopic surgery for retrocaval ureter performed in a single centre and to assess the short-term outcomes of patients treated with this surgical approach. Materials and methods: Eight patients underwent retroperitoneoscopic transposition of ureter between March 2014 and November 2016, A 3-port, ballon-dissecting, retroperitoneal approach was used, no open conversion was required. Follow-up studies were performed with intravenous urography and ultrasonography. Results: Mean operating time was 121 minutes (range 92-178) and mean anastomotic time was 56 minutes for all cases. Blood loss was minimum. None of the patients required blood transfusion. No intraoperative complications occurred. Hydronephrosis in all patients were decreased substantially after surgery. Conclusion: Our results have demonstrated that retroperitoneoscopic transposition of ureter is an excellent minimally invasive treatment option for a retrocaval ureter that can be accomplished quickly and safely. KYAMC Journal Vol. 9, No.-4, January 2019, Page 173-176

Background: Urolithiasis is one of the most prevalent urological disorders and the prevalence of urinary stones has increased world wide1. The management of urinary calculi was revolutionized by the introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980 and the first successful ESWL treatment was accomplished in Germany by Dr. Christian Chaussy using a Dornier HM1 lithotripter. ESWL is a safe, effective and non-invasive method2.Purpose: To observe the outcome of pushback stenting and ESWL versus in situ ESWL for upper ureteric stone.Materials and methods: It was a quasi-experimental study. The study was under went in the department of urology, Dhaka Medical College and Hospital, between July'2012 to June'2014. Total 60 patients of single upper ureteric stone who satisfy inclusion and exclusion criteria were enrolled in this study. Selected patients were dived into two groups, group A and group B. Group-A for pushback stenting and ESWL and group-B for in situ ESWL. Results were compared in terms of clearance rates, number of shock waves, sessions, incidence of complications and failure rate.Results: Failure of ESWL was significantly higher in Group B (23.33%) than Group A (10%). These results were statistically significant.Conclusion: Pushback stenting and ESWL is better than in situ ESWL for upper ureteric stone.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 4-9